Senior Pharmacist - Strategy

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Senior Pharmacist - Strategy

Work At Home - Pennsylvania, Home PA 90001, United States

Full time

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Job DescriptionWorking with UsBenefits & PerksHear From Our TeamHow We Hire

Job Details

Category Pharmacy

Type Full time

Location(s) Work At Home - Pennsylvania, Home PA 90001, United States

Brand Highmark Inc.

Posted 11/10/2026

Req ID J289855

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Job Description

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This role operates in a hybrid model (T,W,TH) for employees residing within 50 miles of the corporate office.

This job works in a team-oriented environment monitoring FDA-approvals, drug manufacturer pipelines, and assessing drug utilization reports, to develop and execute the the organization"s drug formulary, and develop pharmacy utilization management policies, and maintains compliance with federal, state, and other mandates. The incumbent may write drug monographs for committee review; develop and implement the organization"s management programs including but not limited to: prior authorization, dose and duration edits, quantity limits, step-care edits, generic sampling, pharmacy policy review and development and/or review of member specific information to improve individual outcomes. The incumbent develops and implements physician, pharmacy, account, and member educational initiatives that promote the organization's formularies, utilization management programs, and participates on cross-functional committees to develop and implement clinical and operational initiatives, working in close collaboration with matrix partners and stakeholders across the organization. The incumbent may interact with pharmaceutical manufacturers, the pharmacy benefit manager, and/or strategic partners to implement clinical formulary and utilization management strategies. The incumbent may provide guidance to more junior team members, participate in evaluating, implementing, and monitoring pharmacy benefit-focused federal and state legislation, develop, execute, and monitor pharmacy-specific strategic initiatives, and/or present recommendations to leadership.

ESSENTIAL RESPONSIBILITIES

• Formulary & Utilization Management Strategy & Development: May lead Highmark's evidence-based medicine drug evaluation program supporting Highmark's formulary and utilization management (UM) and/or pharmacy program strategy. Develop pharmacy formulary and UM program initiatives supporting Highmark Enterprise Customer Value Creation (C2V) program savings goals. Assist in the development of drug formularies by monitoring FDA-approvals and drug manufacturer pipelines, assessing drug utilization reports, and writing drug monographs for Pharmacy & Therapeutics Committee review, as applicable. Assist in the development and implementation of utilization management programs including but not limited to: prior authorization, dose and duration edits, quantity limits, step therapy edits, generic sampling, pharmacy policy review and development and/or review of member specific information to improve individual outcomes.
• Regulatory Compliance & Oversight: Execute Highmark's Pharmacy & Therapeutics Committee charter and program compliance in accordance with regulatory standards. Support regulatory compliance related to the organization's prescription drug benefit, formularies, and pharmacy utilization management policies. Manage formulary administration and oversight, ensuring all aspects of work adhere to applicable state and federal requirements. May represent Highmark in applicable state or federal audits.
• Strategic Collaboration & Analytics: May partner with internal analytics organization and external pharmacy vendors (as applicable) to generate real-world evidence insights to support of Highmark pharmacy strategy. Participate in cross-functional committees to develop and implement clinical and operational initiatives within the organization with focus on pharmacy.
• Quality Assurance & Review: Serve as a peer-reviewer of medication reviews, pharmacy utilization management policies, and other strategy deliverables, as applicable.
• Education & Communication: Develop and implement physician, pharmacy, client, and member educational initiatives that promote the organization"s pharmacy strategies including formularies, utilization management programs, and other pharmacy programs.
• Project Management & Process Improvement: Identify and assist in managing department process improvements to maximize overall efficiencies. Manage individual projects for timely review with leadership.
• Team Guidance & Mentorship: Provide guidance to more junior team members.
• Other duties as assigned or requested.

EXPERIENCE

Required

• 5 years of related, progressive experience in the pharmacy area of specialization OR completion of an accredited PGY-1 Managed Care Pharmacy Residency Program plus 2 additional years of related, progressive experience in the pharmacy area of specialization

Preferred

• Progressive experience in pharmacy strategy, formulary administration, pharmacy program or product development within a health system, health plan, or pharmacy benefit manager setting

SKILLS

• An understanding of managed care pharmacy principles and practices is essential
• Demonstration of strong verbal and written communication skills, as well as proficiency in the use of computer-based data processing
• Microsoft Office products, and database applications
• Be able to quickly identify and prioritize essential elements of problem
• Independently or in a team, be able to identify the root issues and formulate potential solutions

EDUCATION

Required

• Bachelor of Science in Pharmacy or a Doctor of Pharmacy degree

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• Registered Pharmacist (Non-State Specific)

Preferred

• Board Certified Pharmacotherapy Specialist
• Board Certified Geriatric Pharmacist

Language (Other than English):

• None

Travel Required:

• Less than 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

• Office-Based or Remote Position

Physical work site required

• Frequently

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$118,400.00

Pay Range Maximum:

$196,800.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Why Choose Highmark Inc.?

As one of the nation"s leading health insurers, Highmark Inc. relies on a passionate team of over 5,000 people to make healthcare higher-quality, accessible, and affordable. We are known for how deeply we care-about our members and our employees. If you are looking to build a career with real purpose, you belong at Highmark.

Benefits & Perks

Taking Care of You

Your Benefits at a Glance

• Health: Complete medical, dental, vision, prescription, HSA, and FSA coverage.
• Time Off: Paid vacation, holidays, and dedicated volunteer time.
• Finance: Employer-sponsored 401(k), life/disability insurance, and tuition reimbursement.
• Perks: Exclusive team discounts on shopping, memberships, and events.

Medical Coverage

Medical, prescription drug, dental, and vision coverage

Paid Time Off

Vacation, holidays, volunteering

Retirement Package

Employer-sponsored 401(k) plan

Insurance & Coverage

Life, AD&D and disability insurance

Onsite & Preventative Care

We make staying healthy easy with 100% covered preventative exams (including flu shots) and onsite pharmacy services at major campuses. Plus, stay active with free fitness center access at major Highmark campuses, Allegheny General, and West Penn Hospital.

Make Mindful Changes

Secure bicycle parking at major campuses. Healthy food options at onsite cafeterias. Stress management classes including yoga, mindfulness, and meditation.

Holistic Support, 24/7

Work-life resources including assistance programs and financial counseling services. 24/7 telephone access to health and wellness coaching.

Get Rewarded for Giving Back

Health incentive program that rewards team members. Team member networks to gather in the name of health. Paid volunteer time and incentives for making a difference.

Hear from Our Team

Real people, real stories

"I have met some really great people over the years at Highmark Health and the company has treated me really well. I get really good benefits. I"ve always been rewarded for working hard. That"s what keeps me here."

Victoria T.

Associate Strategy Analyst, enGen

"I love participating with the PRIDE BRG. It"s an engaged, dynamic group of almost 400 people. I also love to turn on the digital hub on my computer and see what"s going on with any of the Business Resource Groups. It"s really neat to be able to support other BRGs and see others support PRIDE. Every time I go to a different BRG event, I always feel welcome, even if I"m not part of that group."

Amanda M.

Director of Social Determinants of Health | Vice Chair of PRIDE

Our Hiring Process: Step-by-Step

1. Apply

Find a role that sparks your passion and submit your application! We'll send an immediate confirmation email, and our team will review your qualifications over the next 1-2 weeks.

2. Interview

If your profile is a great match, we'll reach out to schedule your interview-whether by phone, video, or in person. Don"t worry, we'll provide all the prep details in advance so you can shine.

3. Job Offer

The moment you've been waiting for! If selected, we'll connect to celebrate and walk you through the details: compensation, benefits, paid time off, and all the perks of joining the team.

4. Pre-Employment

After you accept online, we'll guide you through standard screening (including a background check and drug screen, plus health screenings for certain clinical roles). Once cleared, we"ll officially confirm your start date!

5. Onboarding

Welcome aboard! Before Day 1, we'll send everything you need to hit the ground running-including your schedule, location, and the required identification documents to bring with you.

Bonus Fast-Track Tip

Applying for EVS, Dietary, or Customer Service roles? You can skip the traditional line and chat with Bridget, our AI recruiting assistant, to find open roles and schedule an eligible interview instantly.

Apply Now

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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